I don't understand the Surgery Rotation

[IR3A4]

Like all the residents are telling me I should be trying to get into the OR as much as possible, when I got downtime I should be in the OR.


... why? so I can stand there and learn nothing?

If surgeons with students described everything they were doing, why they were doing it, this approach over that, etc etc. hell I'd wanna be in the OR all the time. Instead, they seem bothered when you ask questions, and when they answer they give you a quick and simplified answer that's usually pretty "well no ****"


I can't imagine this experience is different in most other places. Either way, I'm gonna just start dodging the OR and do UWorld questions.

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[IssaDr]

I'm sorry to hear your rotation isn't going well. I'm on my surgery rotation too, and I think it's very doctor dependent. My surgeon is super chill, doesn't pimp me often, answers all of my questions, and his first assist explains a lot to me while he's doing his surgeries because he uses the DaVinci for most of his procedure. This also leads to me practicing my tocar placement and stitching up tocar holes under his and the first assist guidance. He doesn't require me to be on-call while he's on-call, but since I expressed interest in seeing as many cases as possible, he text me when he does get a case so I can come scrub in. I'll even be working with one of his partners while he's out of town, and she too lets us students help with quite a bit. Maybe see if your surgeon has a partner you can work with under the guise of wanting to see how various surgeons go about do similar procedures.

 

[Smurfette]

I went into surgery, so obviously I liked my surgery rotation. I liked it because I could actually DO things. Remove drains. Put in NGs and foleys. suture skin closed. Put in trocars. See and feel stuff in surgery. Check xrays and have residents actually look at them and go over it with the students who were around and not just look at the radiology read. Loved as a student to get the chance to draw blood or do some other skill. Way better than other rotations where they took hours to round and come up with a plan. Some people prefer the latter. But that's why I'm a surgeon and others aren't.

 

[IR3A4]

I went into surgery, so obviously I liked my surgery rotation. I liked it because I could actually DO things. Remove drains. Put in NGs and foleys. suture skin closed. Put in trocars. See and feel stuff in surgery. Check xrays and have residents actually look at them and go over it with the students who were around and not just look at the radiology read. Loved as a student to get the chance to draw blood or do some other skill. Way better than other rotations where they took hours to round and come up with a plan. Some people prefer the latter. But that's why I'm a surgeon and others aren't.

Gosh, I wish it was like that here haha. Just being able to do something is nice.

 

[ACSurgeon]

Like all the residents are telling me I should be trying to get into the OR as much as possible, when I got downtime I should be in the OR.


... why? so I can stand there and learn nothing?

If surgeons with students described everything they were doing, why they were doing it, this approach over that, etc etc. hell I'd wanna be in the OR all the time. Instead, they seem bothered when you ask questions, and when they answer they give you a quick and simplified answer that's usually pretty "well no ****"


I can't imagine this experience is different in most other places. Either way, I'm gonna just start dodging the OR and do UWorld questions.

You seem to have an attitude problem. Might be just coming across poorly in written form.

You want the surgeon to talk to you about the steps and indications etc? Did you make an effort before coming to OR to learn those things? If you did, it opens a lot more room for discussion. Even if not during the case, you’d be able to chat with the residents about it and you’d get a lot more from being in OR. Most of my med students show up not knowing anything about the patient or which surgery we are doing. Then they get offended that I’m not interested in teaching them or letting them do cool stuff

Your time on surgery is meant for you to see if you want to be a surgeon and get a sense for what the surgery team is doing and how it effects the patient. If you pay attention, you’ll pick up some pearls that put things in perspective and makes studying less boring.

 

[IR3A4]

You seem to have an attitude problem. Might be just coming across poorly in written form.

You want the surgeon to talk to you about the steps and indications etc? Did you make an effort before coming to OR to learn those things? If you did, it opens a lot more room for discussion. Even if not during the case, you’d be able to chat with the residents about it and you’d get a lot more from being in OR. Most of my med students show up not knowing anything about the patient or which surgery we are doing. Then they get offended that I’m not interested in teaching them or letting them do cool stuff

Your time on surgery is meant for you to see if you want to be a surgeon and get a sense for what the surgery team is doing and how it effects the patient. If you pay attention, you’ll pick up some pearls that put things in perspective and makes studying less boring.

It's just coming off poorly in written form. For the sake of tooting my own horn, I'm quite engaged, informed, knowledgeable, and have gotten very good evals.

I spend my weekends reviewing cases ahead of time, which is where I ask my questions from. In fact, the one surgeon I've gotten to work with who was actually receptive applauded my knowledge base. Unfortunately they're not on a service I'm on and were just filling in for night float.

My residents have very little desire to chat, they're running around constantly and when I try and stop for a question they'll tell me we can cover it later, and later never comes (and after reminding someone twice I've stopped as I didn't want to be a pest since they have an actual job to do)


Ofc I've picked up some pearls. But doing 14hr days to pick up a pearl or two here or there hardly seems efficient. I'm going further into debt to learn.

 

[mvenus929]

You seem to have an attitude problem. Might be just coming across poorly in written form.

You want the surgeon to talk to you about the steps and indications etc? Did you make an effort before coming to OR to learn those things? If you did, it opens a lot more room for discussion. Even if not during the case, you’d be able to chat with the residents about it and you’d get a lot more from being in OR. Most of my med students show up not knowing anything about the patient or which surgery we are doing. Then they get offended that I’m not interested in teaching them or letting them do cool stuff

Your time on surgery is meant for you to see if you want to be a surgeon and get a sense for what the surgery team is doing and how it effects the patient. If you pay attention, you’ll pick up some pearls that put things in perspective and makes studying less boring.

I mean, I did trauma surgery for part of my surgery rotation, which was ICU based since we didn't actually have a lot of traumas while I was on. So, sometimes the trauma surgeons would call us down to do general surgery cases (which they did while not on service/call) with 5 minutes notice. And then the residents would get mad that I knew nothing about the patient--not much I can learn when I have to run down from the trauma ICU to the OR and scrub in just as the patient is getting rolled back. I helped with the prep and draping and such, and then just held the camera for most of the case, but rarely had any idea what the surgery actually was before the pause.

 

[operaman]

Sounds like you may have some duds for preceptors.

The biggest thing that determines what I let students or residents do in the OR: how comfortable I am with what I’m doing. Routine stuff I feel totally good about, sure I’ll teach more and even take students through cases. I’ve taken a couple strong M3s through simple stuff like trachs where they feel like they’re doing the case while I’m actually doing it with the retractor. If it’s something weird where I’m not comfortable myself, I don’t usually let anyone else touch anything.

The next thing that determines it is how interested and prepared a student is. If they’ve prepared and know the patient and have clearly read, then I’m much more excited about getting them involved because it’s more fun for me. Taking a clueless person through a case is not fun at all. In my field I also run into the issue that most of my cases are single operator, so it’s especially hard to let a novice do that much. Even so, I’ll often let a student do a couple simple moves just a get a feel for working under the scope or using the instruments.

Sounds like you’re working hard at your own preparation. Sadly not much you can do about how comfortable your staff are. I can say it usually says more about them than it does you - maybe they’re having some bad outcomes or under other pressures, or maybe the residents kinda suck and they’re struggling to teach them and keep them from screwing the pooch.

Just keep preparing and studying and trying to learn what you can. Watch videos of surgeries ahead of time so you have a good sense of what happens when and can start noting differences in technique.

Truthfully you can learn a TON by watching, but you do need a certain level of skill before that really works. Most students just aren’t there yet. But try and look past the poor preceptor and get a sense of whether being a surgeon is a good fit for you.

 

[NonNocere]

Like all the residents are telling me I should be trying to get into the OR as much as possible, when I got downtime I should be in the OR.


... why? so I can stand there and learn nothing?

If surgeons with students described everything they were doing, why they were doing it, this approach over that, etc etc. hell I'd wanna be in the OR all the time. Instead, they seem bothered when you ask questions, and when they answer they give you a quick and simplified answer that's usually pretty "well no ****"


I can't imagine this experience is different in most other places. Either way, I'm gonna just start dodging the OR and do UWorld questions.

Do not ask questions while in the OR. They will ask you questions. Speak only when spoken to, I think that was the rule.
Are there any other reasons you feel you are not learning in the OR?
Pay attention to what is going on. Do what you are told to do. You have probably not seen surgery before. So, everything you are seeing is probably new to you.

 

[SunBakedTrash]

Surgery is more fun to do than to watch. Pathology is the same way, and i’m sure most fields of medicine are. I felt the same way as you in med school OP, but came to appreciate this fact as a pathology resident. Look past the limitations of the crap medical school rotation and try to see if you would like the attending’s job and could handle the resident’s job for 5+ years.

 

[Angus Avagadro]

As a new MS1, you feel like you don't know anything, because you don't. Making the change from MS2 to MS 3 on an early surgery rotation is another adjustment; you pretty much still don't know anything clinical and aren't qualified to do help out on the rotation. MS3 is absorbing as much as you can and to prepare for each day. The days of I'm here, so where is my bedside lecture and my scalpel?...aren't coming. There will be a small amount of didactic, but mostly observing, absorbing, and hopefully being guided by a resident or MS4. I can remember that time being rather frustrating and now realize it's normal. You will get up to speed. Try not to be too impatient. Read ahead, prepare, show up early, never late, and ask to do a presentstion on an interesting patient if you arent getting much teaching. Good luck and best wishes.

 

[CanIBeAnonymous]

Do not ask questions while in the OR. They will ask you questions. Speak only when spoken to, I think that was the rule.
Are there any other reasons you feel you are not learning in the OR?
Pay attention to what is going on. Do what you are told to do. You have probably not seen surgery before. So, everything you are seeing is probably new to you.

Some sites / some attendings
... they dont speak?
... they don't tell you to do anything?
... half the time you can barely see what's going on because there's an attending and 2-3 residents in the OR?

Legitimately only had one attending do any of the above when I was on my rotation.

This is horrible advice to OP and anyone here.

 

[IR3A4]

As a new MS1, you feel like you don't know anything, because you don't. Making the change from MS2 to MS 3 on an early surgery rotation is another adjustment; you pretty much still don't know anything clinical and aren't qualified to do help out on the rotation. MS3 is absorbing as much as you can and to prepare for each day. The days of I'm here, so where is my bedside lecture and my scalpel?...aren't coming. There will be a small amount of didactic, but mostly observing, absorbing, and hopefully being guided by a resident or MS4. I can remember that time being rather frustrating and now realize it's normal. You will get up to speed. Try not to be too impatient. Read ahead, prepare, show up early, never late, and ask to do a presentstion on an interesting patient if you arent getting much teaching. Good luck and best wishes.

Thanks for the advice, I appreciate it.

Honestly I think a lot of my frustration is with my clinical site. It's a new site, at a non-academic hospital and half the time they seem annoyed that they have med students now. Legit walked into a new service and someone yelled "what the **** they said they were going to tell me if med students were coming in any time soon, ugh" looked at me, rolled their eyes, and then gave me a talk as though I was a child (I'm 32).

I'm only bitching here because I can't in person, I keep up appearances, I'm "approachable and amicable" but knowing how much I'm paying to attend a site that doesn't even want us is beyond frustrating.

 

[NonNocere]

Some sites / some attendings
... they dont speak?
... they don't tell you to do anything?
... half the time you can barely see what's going on because there's an attending and 2-3 residents in the OR?

Legitimately only had one attending do any of the above when I was on my rotation.

This is horrible advice to OP and anyone here.

I am sorry you feel that way, however that is seriously what I remember being told. It is not a policy I am coming up with myself, friend. Surgery is a risky endeavor which requires concentration. Your goal is supposed to be, stand there and learn by seeing what is going on. Once they trust you, they will ask you to do things. Asking residents about the surgery afterwards is another suggestion I was going to give you. The rotation is already over? My advice isn't horrible, it worked quite well, and for me it is understandable why it works that way in the OR. It sounds like you had a bad experience. There are reasons it works like that and it seems like you don't understand. Best of luck.

 

[IR3A4]

I am sorry you feel that way, however that is seriously what I remember being told. It is not a policy I am coming up with myself, friend. Surgery is a risky endeavor which requires concentration. Your goal is supposed to be, stand there and learn by seeing what is going on. Once they trust you, they will ask you to do things. Asking residents about the surgery afterwards is another suggestion I was going to give you. The rotation is already over? My advice isn't horrible, it worked quite well, and for me it is understandable why it works that way in the OR. It sounds like you had a bad experience. There are reasons it works like that and it seems like you don't understand. Best of luck.

Pretty sure what they're saying is maybe you had a rotation at a good institution, but they like myself do not.

Glad you had a good rotation where it worked out that way Not all of us get to be at institutions like that.

 

[NonNocere]

Pretty sure what they're saying is maybe you had a rotation at a good institution, but they like myself do not.

Glad you had a good rotation where it worked out that way Not all of us get to be at institutions like that.

It's possible. Do you have any more questions?

 

[CanIBeAnonymous]

I am sorry you feel that way, however that is seriously what I remember being told. It is not a policy I am coming up with myself, friend. Surgery is a risky endeavor which requires concentration. Your goal is supposed to be, stand there and learn by seeing what is going on. Once they trust you, they will ask you to do things. Asking residents about the surgery afterwards is another suggestion I was going to give you. The rotation is already over? My advice isn't horrible, it worked quite well, and for me it is understandable why it works that way in the OR. It sounds like you had a bad experience. There are reasons it works like that and it seems like you don't understand. Best of luck.

What? I'm assuming you didn't read my post then. Dude, every attending but one had me stand where I couldn't see. There's no way to build trust with someone by just standing in a corner watching peoples back.

I had one attending that was great, they let me do everything. There is legitimately no excuse for the others. And your advice is horrible if you think it's universal - not ever institution is the same, and if you can't understand that then Idk what to tell ya lol

 

[NonNocere]

What? I'm assuming you didn't read my post then. Dude, every attending but one had me stand where I couldn't see. There's no way to build trust with someone by just standing in a corner watching peoples back.

I had one attending that was great, they let me do everything. There is legitimately no excuse for the others. And your advice is horrible if you think it's universal - not ever institution is the same, and if you can't understand that then Idk what to tell ya lol

I read your post. Medical students in the OR should stand somewhere where they can see as much as possible. Granted sometimes it gets crowded. I wasn't there, so I don't know what happened.

You're still saying my advice is horrible, but I'm not exactly sure what you're disagreeing about. You think in some ORs the medical students should be asking the surgeons questions while they are operating?

Obviously, if a medical student is instructed to do something by a resident or attending, that is what they should do. I was just sharing my experiences, which were good overall, from surgery rotations in medical school, which are from a long time ago.

I also want to suggest to you that you work on your attitude. One aspect of professionalism is how you communicate with other MDs. There are better ways to give feedback and have discussions than using words like horrible.

 

[CanIBeAnonymous]

I read your post. Medical students in the OR should stand somewhere where they can see as much as possible. Granted sometimes it gets crowded. I wasn't there, so I don't know what happened.

You're still saying my advice is horrible, but I'm not exactly sure what you're disagreeing about. You think in some ORs the medical students should be asking the surgeons questions while they are operating?

Obviously, if a medical student is instructed to do something by a resident or attending, that is what they should do. I was just sharing my experiences, which were good overall, from surgery rotations in medical school, which are from a long time ago.

I also want to suggest to you that you work on your attitude. One aspect of professionalism is how you communicate with other MDs. There are better ways to give feedback and have discussions than using words like horrible.

You're preaching your advice as though it is universal. Your experience is from your one rotation, and as you admit from a long time ago. It doesn't necessarily apply to today or to other folks specific rotation sites or preceptors, so yes I find the advice to be horrible and will state it as such. I appreciate your input to the discussion, as it shows how different rotations can be, but your "holier-than-thou" attitude could be worked on.

Also, that one attending I liked, if you didn't ask questions during his operations he considered people bored, lazy, unenthused, or unknowledgeable. So as I said, your advice isn't universal.

 

[NonNocere]

You're preaching your advice as though it is universal. Your experience is from your one rotation, and as you admit from a long time ago. It doesn't necessarily apply to today or to other folks specific rotation sites or preceptors, so yes I find the advice to be horrible and will state it as such. I appreciate your input to the discussion, as it shows how different rotations can be, but your "holier-than-thou" attitude could be worked on.

Also, that one attending I liked, if you didn't ask questions during his operations he considered people bored, lazy, unenthused, or unknowledgeable. So as I said, your advice isn't universal.

Sorry if you didn't like my tone. I was just speaking from experience. I worked with multiple surgeons in medical school and I don't recall that any of them encouraged interrupting with questions. Typically they would pimp the medical students. Maybe it was an institutional culture thing.
If an attending tells you to do something, of course that is what you should do. Best of luck.